Teens enter my office for many different reasons. Most times, parents initiate the contact. Other times, it’s schools. Adults’ concerns are usually—and correctly—about the teen’s safety. So, teens who have problems with self-injury, suicidal thoughts, and aggression are often identified and sent to someone like me. Other behaviors that prompt such action include defiance, oppositional behavior, school refusal, argumentative behavior, and social isolation.

And so treatment begins. And sometimes it’s brief. And more often it’s longer. And when their behavior is regulated, when teens are no longer self-injurying or suicidal, aggressive or using substances…we find the underlying problems. What’s underneath all this unsafe behavior? Would you guess…social anxiety? In my office, I’ve seen a higher-than-expected number of self-injurying teens who actually—before all the unsafe behaviors—had developed Social Anxiety Disorder. And they still have it. Because these kids can be outrageous in appearance and behavior, people often suppose they have similarly bold personalities. Not true.

These teens scowl because they feel as if they are in the glare of the public eye, and that the public is waiting to criticize them. They don’t scowl because they hate the system.

These teens break eye contact not because they don’t like you, but because looking you in the eye paralyzes them with a flood of adrenaline.

These teens end conversations quickly because they are over-analyzing the situation and struggle to think of what to say next. They don’t stop talking because they think you’re boring or stupid.

These teens prefer the company of one close friend—or of no one at all—not because they can’t stand people, but because they can’t stand how they feel around people. It’s miserable.

When I ask these teens how others describe them, one word keeps coming up: “Intimidating.” Their peers tell them that they are intimidating, that they don’t seem to like anyone, and that they are kind of scary. People assume these teens are irritable and that they are verbally or physically dangerous.

But they are none of these, really. They are consumed by a sometimes-panic level of anxiety when they are in social situations. So they’ve found ways to hide anxiety. Some dress in crazy fashions. Others isolate. Some use drugs to feel comfortable around others (this only makes anxiety worse down the road; it’s not a solution). Some teens act obnoxious and outrageous.

Of course, not all self-injurying teens have Social Anxiety Disorder. Many teens dress in crazy clothes because they just like them; they’re not hiding anything. And of course, teens can be obnoxious without any diagnostic label.

But take a look at yourself and your friends…could there be anxiety under all that behavior? If you fix the anxiety, you’ll be more effective. You won’t have to do those things that get you in trouble or draw negative attention. You’ll feel well, again. Like you did when you were a little kid.

It’s not that your opinion doesn’t matter (although, to your teen, it probably doesn’t). It’s that your child does not believe you. And, your nice words don’t help. They may even hurt.

Most teens I’ve worked with seriously doubt the motives behind their parents’ compliments. Some explain: “My mom says I’m pretty because she feels sorry for me,” “My dad says I’m smart because he has to. He’s my dad,” “My parents say I’m good just to make me feel better.” These teens can twist warm parental encouragement into a shaming experience.

Think of it this way. Imagine (or remember when) your son fell off his bike at age 5, and you announced cheerfully: “You’re fine! Just keep going!” But he actually didn’t feel fine. He was really hurt. Your encouragement may have invalidated his experience. He did not feel understood or supported.

The child who puts herself down does not accept herself. When you insist that she is thin, etc., it invalidates her. She wasn’t understood or supported.

You’ve heard of “vicious cycles…” When you respond with emotional warmth and encouragement to your child’s self-criticisms…you may actually be rewarding her non-acceptance of herself. He learns that he gets flattery and reassurance (even if it’s not totally believable and certainly not enduring) for putting himself down. In a low mood, in a time of self-doubt, she may increasingly berate herself, unconsciously expecting warmth and encouragement. As she negatively judges herself, you amp up compliments, she judges more negatively, and so on.

Self-Criticism through the Ages: How to Respond

Ages 3-4: Surprise: even youngsters this age can come down pretty hard on themselves. Many times, it takes the form of self-harm, such as banging their head on a wall or smacking their face when upset or frustrated.

Ages 5-6: Fit and active children as young as this (boys and girls) have told me they’re “fat.” Body image is no longer just a teen thing. However, self-criticism at this age is more often related to (1) negative mood, (2) frustration, and (3) fears that he/she has disappointed others. Some children may hurt themselves physically. Others use words: “I can’t do this,” “I’m stupid.”

TRY THIS:

Be aware of modeling. Assuming you do not hurt yourself (please don’t do that), your child may be picking up on your self-criticism or overly rigid self-expectations.

Respond to your child as follows. Imagine he has hit another kid, to get you into this mindset.

Adopt a “stop-the-press!” attitude. Stop what you are doing. Look squarely at your child. Without being harsh, be firm. Wear a stern face. Matter-of-factly say, “You are being a bully to yourself. That is not ok. If you do it again, you will get a time out.” If your child repeats it, follow through on time out. If your child stops, wait 1 minute. WAIT. (You do not want to accidentally reinforce self-bullying).

After 1 minute (or after time out): Warmly approach your child and explain what happened: “You spilled the juice on the carpet. That was a mistake. You feel bad about it. I’m pretty irritated, too. But mistakes happen. I really like that you care so much to do the right thing. That’s a nice thing about you. You may not bully yourself. Nobody bullies my kid! Help me clean up this mess now.”

Ages 7-9: The developmental task for these kiddos is to develop industry, to decide if they are skillful, motivated, driven, and productive individuals. This is often decided as they compare themselves to others. This age is where self-esteem starts to solidify. Your opinion as a parent is still very important to your child. Self-criticism at this age may stem from viewing peers are more successful/able/capable/attractive/popular, etc. You may expect unflattering comments related to these.

Ages 10-14: The focus turns more and more toward friends and peers. Your opinion matters less and less. Self-criticism that starts at this age can be a sign of depression and low self-esteem. Ongoing self-loathing has dire social consequences; it is hard to make friends if you don’t like yourself. Occasional self-doubt may be common. It will most often relate to how she sees herself compared to others of her age and gender. A likely source may be peer comments and bullying. Particularly girls who enter puberty early are at risk of negative attention.

Do not let comments go unacknowledged. Giving full attention to your child, say matter-of-factly: “That was a mean thing to say to yourself. Wow.” Your child will probably reassert her self-criticism. Avoid the impulse to correct her or praise her.

Say, “Help me understand that. How are you fat?” Walk your child through a step by step evaluation of his thought process. Continually ask, “What is the evidence?”

What if there is evidence? What if your child is fat? Then, you problem-solve with her. Make an appointment with her pediatrician. Discuss diet and exercise, revising grocery lists, family walks, etc. Make a plan and follow through. All the while, support your child’s self-esteem. Tell her not to bully herself.

Be aware of the validity in your child’s statements. He is probably not the best player on the team. So, what can he do about that? If he wants to improve, help him develop a self-guided practice routine. All the while, support his self-esteem.

You will probably find what’s called a “cognitive error.” It may sound like this: Because I don’t understand algebra, I’m stupid. Explain that error to your child.

Change your tactic. Say, “You are good friend. I notice that you encourage, support, and are gentle with your friends. If your friend did not understand algebra, would you tell him he’s stupid?” You will likely discover that his self-rules do not apply to others. Follow this line of reasoning, with the goal of helping your child develop insight into his overly-high self-standards. “Why are the rules different for you?” Explain that he is bullying himself, and that it won’t be tolerated. Offer to assist him with homework or to find academic supports for him.

Ages 15-19: Self-criticism at this age probably stems from a history of failed attempts at relationships, tasks, or improvements. With teens, there can be a range of triggers for self-criticism. Even if your child only occasionally states self-loathing, it’s probably true that she has chronic negative self-statements in her psyche. Depression may be very likely. Children this age are capable of deeper reasoning, understanding, and dialogue. The self-bullying speech will probably interest him, but not have much effect on curbing self-criticism.

Do not let comments go unacknowledged. Giving full attention to your child, say matter-of-factly, “Whoa. That was a tough thing to say about yourself! Are you okay?” Avoid the impulse to correct her or praise him.

Initiate a dialogue, the goal of which is to show how the self-criticism is mood-dependent—it comes from your child feeling sad, anxious or irritable.

If the comments are not mood-dependent, and made in a cavalier, joking way, say, “That is not acceptable or funny. And it’s not a good habit. Please stop that.”

More likely, the comments are mood-dependent. Help your child identify what triggered the statement, what the mood is, and what she can do to improve her mood. Help her generate coping skills to feel better: listen to music, watch TV, go for a walk, call a friend, read a book, play with the dog, take a shower…

Your child may admit, “Even if I were popular / thin / smart/ athletic, I still would not like myself.” If so, make an appointment with a mental health professional.

Parents want their child’s IQ tested for a variety of reasons. Some are seeking admission to elite schools, where a score in the gifted range is a prerequisite. Others want to know if their child has a learning disability (fact: most people with learning disabilities have average or higher IQ). Still other parents are curious about their child’s intellectual strengths and weaknesses. Lastly, many parents understand the value of incorporating an IQ test into a battery of psychological tests for diagnostic purposes.

Widely-used IQ tests in Illinois include the Wechsler series. David Wechsler was an American psychologist who created IQ tests for adults, children, and very young children. Although he designed the tests several decades ago, they’ve gone through revisions and updates.

Children as young as 2.5 through 6 years old are eligible to take the Wechsler Preschool and Primary Scale of Intelligence (WPPSI). Children ages 6 through 16 years old are eligible to take the Wechsler Intelligence Scale for Children (WISC). When a high IQ is suspected in a 6 year old, the WISC is usually administered.

To optimize performance, most kids should take the IQ test in morning hours. (The exception is the rare “night owl” whose thinking is sharpest in afternoon or evening hours). Avoid scheduling an IQ test to occur after school; mental fatigue is likely to detract from your child’s performance.

Depending on your child’s age and test-taking style, IQ tests usually last between 1.5 to 3 hours. Typically, younger children require less time to test. Many children (especially younger ones) need to take breaks between subtests. Snacks, games, a walk outside, or other non-thinking activities are part of testing youngsters. Breaks help them test better.

The IQ test is actually a set of subtests. Children have described the subtests to me as, “kind of like school but funner,” and “like a game sometimes,” “tricky a little,” and “OK.” Your child’s subtest scores are compared to the scores of others within 3 months of his/her age.

IQ is not just one number. IQ tests yeild as many as 15 subtest scores, 4 index scores, and a Full Scale score. Each of these scores is associated with raw scores, percentile ranks, and more. The most meaningful IQ report will include a sea of scores…in a very understandable way.

In order to do well on the IQ test, a child must be: (1) motivated to do his/her best, (2) engaged, (3) focused, and (4) emotionally regulated. A child can do poorly on an IQ test for a variety of reasons, but can do well only if truly able. So, IQ scores can underestimate but not overestimate your child’s intellectual functioning.

Preparing your child for the IQ test should include: ensuring a good night’s sleep, a healthy breakfast (whole grains, fruit, and/or proteins), and the selection of comfortable clothing.

If your child is sick the morning of the test, cancel the test. Even over-the-counter medicated children should be called in sick. Be aware that many medications for colds and allergies can decrease mental processing speed…a highly used skill in IQ tests.

You should also talk to your child about the IQ test. But, avoid using the word “test.” It can create unnecessary anxiety. Instead, say something such as: “You’ll be working for a couple hours with Dr. Ann. She has activities planned for you. Some are like what you do in school. Some are more fun, like word games, blocks, and puzzles. You should ask for breaks when you need them. Ask questions if you’re not sure what you’re supposed to do. The work you’ll do is very important because it helps us know how you think and learn best. Please be on your best behavior and try your hardest. There’s no way to fail in your work. Almost every kid sometimes makes mistakes. Just keep trying and do your best.”

The psychologist should help your child feel comfortable upon introductions. Since anxiety can seriously interfere with test performance, the effective psychologist will be sure to use a variety of strategies to make your child feel mentally prepared and engaged.

Several bright and insightful St. Charles High School students recently visited Plum Tree. They’re finishing Psychology courses and had great questions for a clinical psychologist. Here’s what they wanted to know:

No, but society isn’t clear about how to achieve happiness. Particularly teens are bombarded by social media emphasizing fame, fortune, and beauty. In fact, none of these are linked directly to happiness.

I enjoy a challenge. No science seems as complicated and nuanced as that of human thoughts, feelings, and behaviors.

7. Why did you pick to work with children and adolescents?

I’ve always “spoke their language.” This population of people is easily misunderstood. There’s nothing so fulfilling as being the interpreter between a child and his/her caregivers, teachers, and other important adults.

7. What are the measurable criteria you use to assess how well treatment is working?

It varies per person. Every patient has a treatment plan with measurable goals and timelines. I also conduct intermittent screenings with psychological tests to monitor progress. Of course, patient (and parent) feedback is an important part of assessing the effects of treatment.

8. Do you believe the effects of labeling are true? In the way that when a patient is diagnosed with a certain disorder they act in that labeled way and also the people around them treat them differently according to their diagnosis?

A diagnosis is not a judgment; it’s a fact. Just as there are criteria and scientific evidence to medical diagnoses (e.g., diabetes, colds, cancer) mental illnesses have criteria and scientific evidence. So, just as it’s appropriate and effective to label someone with flu symptoms as having the flu, it’s appropriate and effective to label someone with anxiety symptoms as having anxiety.

Diagnoses (or, labels) are tied to evidence-based treatments, scientific literature, and clinical outcomes. So, when a patient is accurately diagnosed, then treatment pathways become clear. It also allows for different treatment providers to speak the same language about what issues/treatment goals are.

Overwhelmingly, patients can be relieved by learning about their diagnoses. They may have felt “different” all along. The knowledge that there is a name, a treatment, and a community of people with similar issues can be—in itself—an effective therapeutic experience.

Of course, there’s still a lot of public stigma around mental illness. People who have it can be embarrassed or feel inept. Since the idea of mental illness can make others uneasy, patients may experience some ostracizing. Public education is needed.

9. In your opinion, what is the most common diagnosis? Has that changed in the last several years, if so, how?

Trending shows that—for pediatric populations—Bipolar Disorder and Autism Spectrum Disorders, are on the rise. ADHD has been on the rise for at least a decade now, too.

10. Do you think that therapy is the best choice for all who may need it?

Many parents ask me if perfectionism is problematic in kids. It can be. It’s all a matter of adaptiveness. Does perfectionism help or hinder your child? In our fast-paced, information-saturated environments, our children need to continually adapt. But, perfectionism can be the opposite–perfectionism can be rigid and unmoving.

Psychologists typically distinguish between two types of perfectionists: the maladaptive one, and the adaptive one. On paper, these two look alike. They often achieve at the same high level. They have similar high standards. But, one of them is miserable: the maladaptive perfectionist.

The maladaptive perfectionist believes that any less-than-perfect work is unacceptable. They can become preoccupied with details so much that the point of the activity is lost. In fact, perfectionism in this form often interferes with task completion. Maladaptive perfectionists can be excessively devoted to work at the expense of leisure and play. They tend to be inflexible about rules, and come across as rigid and stubborn. Transitions or changes in plans can upset them. Maladaptive perfectionists tend to avoid group work, being unwilling to accept or approve of others’ contributions. Maladaptive perfectionists tend do fine in low-stress situations, but when asked to perform or produce they can become ineffective. Even when achieving at high levels, they tend to be less satisfied with their performance. For example, your child may reason, “I shouldn’t have to work so hard for an A+.” Maladaptive perfectionists have high levels of self-criticism. They are more vulnerable to depression, anxiety, eating disorders, and suicide. But, if asked, these kinds of perfectionists often say that perfectionism is their secret to success.

Adaptive perfectionists also have very high self-standards. But their innate desire to excel does not hinge on a flawless performance. These kids recognize that, sometimes, “perfect” can interfere with success. They are able to sacrifice perfectionism when short on resources (i.e., time, money, parent’s help, etc). These children feel good about a job well done.

There is an overlap between perfectionism and giftedness (children with Superior or higher IQ). Perfectionists and gifted children both have: self-discipline, perserverance, and motivation. These “non-intellectual” factors play a signifcant role in IQ; in fact, they’re requisites. To do well on IQ tests and in school, children must be able to:

Recognize, alter, and maintain changes in their behaviors and moods in ways that advance their cognitive performance (self-discipline).

Mentally tinker with something until getting it right, rather than giving up and saying “I don’t know” (perserverance).

Perfectionism can actually interfere with IQ. Very smart children usually do very well on tasks that have no time limit. But when required to work quickly without making mistakes, perfectionistic children can buckle under the pressure. They may be paralyzed by performance anxiety. They may refuse to be rushed, losing time in executing items to perfection.

Perfectionism can also interfere with social development. Children who are overly perfectionistic can become easily frustrated with peers who “don’t get it.” They may hold others to their own high standards, and criticize those who they see as falling short.

Perfectionism is not the same as OCD (Obsessive Compulsive Disorder). Children with OCD show strange behaviors and senseless compulsions. They may obsess about contamination, and so wash themselves in a specific, self-prescribed manner. They may obsess about getting things “just right,” and so rearrange objects into symmetry, touch or do things a certain number of times, or feel compelled to tie and retie their shoes. Frequently, children with OCD obsess about numbers. They may talk about “safe” or “unsafe” numbers, and aim to have items or behaviors occur in “safe” numbers. OCD interferes with functioning at home, at school, and in the community. OCD symptoms require lots of time, sometimes up to hours each day.

Normal child development includes phases of obsessions and compulsions. For example, between the ages of 4-8 many children engage in specific rituals (such as having a specific bedtime process, or wanting parents to respond with specific words). Fears about contamination (“cooties”) can also be common. Hoarding (collecting objects) is normal by the age of 7. Between the ages of 7-11, highly rituatlized and rule-bound play is normal. And, into teenage years, it is common for children to develop obessions about activities or idols.

You can help curb your child’s maladaptive perfectionism in several ways:

(1) Help your child alter her self-talk. She may believe that if someone does a task better than her, she is a complete failure. She may believe that you will criticize her if she makes a mistake. She may believe that others’ respect hinges on her being perfect.

(2) Help your child become aware of his perfectionistic tendencies. Show him that taking time to make every detail perfect delays his progress. Show him that messing up can provide opportunities for new ideas.

(3) Help your child see the positives. Point out what she is good at, and what others are good at. Encourage her to praise others’ abilities. Point out that, even if she did not do something perfectly, she may have had a lot of fun while doing it. Explain that spending positive time with school peers can be even more important than producing a flawless group project.

(4) Lead by example. Reassure yourself that your child will indeed make it in this competitive world. Enjoy learning for its own sake. Don’t obsess over standardized test scores. “Mess up” and be OK with it.

(5) Avoid overemphasizing accomplishments. Act on values that lead to greater life satisfaction, such as: spending time as a family, volunteering in your community, having fun, and doing things you’re good at (e.g., gardening, drawing, etc.).

(6) Don’t protect your child from disappointment. If he wants to quit soccer because he is not the best, encourage him to stick it out. If her school project is sloppy, avoid stepping in and doing it for her. Your child is not fragile. He can handle being disappointed. Defeat is a natural consequence, and there is no better teacher. Managing defeat and disappointment are critical skills children need in transitioning to college and workplaces. They’ll be more resilient if you allow them to “fail” as children.

If your child’s perfectionism cannot be altered, consider consulting with a child psychologist.

Good self-esteem is the ultimate buffer in kids’ lives. It bolsters them during failure. It navigates them through social pressures. It weathers their emotional (and hormonal) storms. It keeps their negative self-statements in check. Good self-esteem encourages kids to try new things. It helps them understand other people, and treat them well. It makes life more enjoyable. Self-esteem is not something kids build on their own. In fact, building self-esteem can have more to do with others than it does with the self.

Parents, your role in your child’s self-esteem is critical. From your child’s birth onward, you get more and more jobs in helping her develop positive self-esteem.

Birth to 1 Year: Good self-esteem starts when babies learn to fulfill their basic needs (love, hunger, comfort) by manipulating parents and caregivers. (“When I cry, Dad hugs me.”) There are 3 jobs for parents.

Love, adore, and cuddle your baby.

Give her everything she demands. There is no such thing as spoiling a child who is 0-6 months old. It takes a newborn a few months to realize he’s actually a separate person from his primary caregiver. (Can you imagine that a-ha moment?) After age 6 months, parents usually notice their child’s manipulation strategies are developing remarkably. You feel like a sucker. Still, meet her needs. But also start to teach effective communication skills. Children between 6-12 months are usually still in the pre-verbal stage; they cannot say what they want. For example, suppose a toy is not working and your son screams and shoves it in your face to fix it. First, validate his frustration (i.e., “Oh, it’s not working? That’s a bummer!”) Second, have him practice handing it to you nicely (i.e., “When you hand it to me without screaming, I’ll help you buddy.”) Third, think out loud as you fix the toy (i.e., “See this thing here. It’s not turning right. If I do this, it will work, see? Here, you try it.”)

Be a model for calm effort in working through problems…and checking the stupid batteries…

1 Year to 3 Years: Good self-esteem means feeling brave and secure enough to explore and try new things. There are 4 more jobs for parents:

Avoid “helicopter parenting” by smothering children. Nothing is so sweet as a safe moment to oneself. Encourage her unaccompanied excursions into the next room. Introduce him to the arts (i.e., banging on kitchen pans for drums). Praise her efforts, and the products of them (i.e., hang up her drawings on the fridge). Kids develop bravery by understanding that caregivers will keep them safe, and will be there if anything gets scary.

Don’t neglect your child. Make sure he is in supervised, child-proofed environments that will not punish exploration with injury. When accidents happen (…do coffee-table manufacturers have toddlers?), validate the injury (“Ouch!”) and explain how it can be avoided in the future.

Tell your child multiple times a day what INTRINSIC qualities you admire in her: sustained effort, working through frustration, showing care for others, athletic ability, smart reasoning, bravery, sense of humor, etc. When your child misbehaves, make a point to discourage the behavior, not the child. (“In our house, we don’t hit. You are not the kind of person who hits. Please take a time out.”) Do not under any circumstances apply negative labels to your child. Labels like “lazy,” “dramatic,” “babyish,” “worry wart,” and other unpleasant character appraisals shame your child, and have no positive impacts. Remember: Attribute good behaviors to your child’s character and bad behaviors to your child’s choices. (Behavior charts are a good way to get kids to behave without harming their self-esteem).

Model good self-esteem. Normalize mistakes. Don’t talk down about yourself. Don’t talk down about your spouse. Toddlers are using your skills to build their own. To children, parents are the most attractive, important, effective, and powerful people in the world. (Feeling better about yourself now?)

3-6 Years: Good self-esteem is being able to do stuff for oneself. There are 3 more jobs for parents:

Encourage and expect your child to take more and more responsibility for his Activities of Daily Living (ADL). These include: showering/bathing, brushing hair/teeth, getting dressed, using the toilet independently, feeding oneself appropriately, using the telephone/computer, taking care of pets, cleaning up after oneself, using safe behaviors (buckling self into the car seat), organizing school materials, and so on.

Expect more from your child. It’s OK if kids don’t get ADLs perfect. In fact, they won’t. But it is important that parents have reasonable expectations for children to try their best at each job. High demandingness is one very important part of good parenting. Mandate good effort in a matter-of-fact way. We all have to do things we don’t want to; that’s part of life.

Praise your child. Give warm support and even over-the-top, exaggerated cheers for jobs well done. Be sure to emphasize how proud you are of your child’s efforts, even if the outcome is not great. It’s not your imagination: your child IS incredibly unique, gifted, wonderful, and a genius at being himself. Let him know that.

6-11 Years: Good self-esteem means comparing oneself realistically to others and, in doing so, seeing self-worth. There are 3 more jobs for parents:

The focus for kids this age turns increasingly away from parents to other people (particularly peers). Kids compare themselves to others and see that there are often major differences. For most kids, differences will be both positive and negative. Your child realizes that he is not the best student in math. She sees that she is a great basketball player. He understands that others are more popular. She gets that other kids have family troubles. He sees that other people have more expensive clothes and gadgets. Parents should verbalize values for intrinsic skills and character, and not necessarily for achievements. Be realistic and positive in appraisals of your child. (“Yes, I suppose he is a better pitcher than you. He has spent a lot of time practicing and he’s sure talented. If you work hard, you may be as good as him. If not, no biggie. You’re great at understanding technology.”) Introduce your child to (books about) heroes of character and effort, not heroes whose only attributes are beauty, fame, or fortune (as they see on TV and other media).

Love the child you have, not the child you wanted to have. It’s time to come to terms with possible disappointments, and with, perhaps, your own childhood “failures.” Focus on the things you admire in your child, not on the ways you see her as falling short of your ideals. Strike the balance between pushing your child to do better and recognizing that she may be doing her very best. Indulge his passions, if they’re safe and appropriate.

Keep close ties with your child’s school. Teachers have valuable information about how your child relates to others. Good schools help teachers structure the classroom in ways that help all children feel accepted. Good teachers ensure that children do not feel inferior.

12-20 Years: Good self-esteem is knowing who you are, and who you are not. There are 3 more jobs for parents:

Teenagers have critical questions to answer about themselves, like “Who am I?,” “How do I fit in?,” and “What am I going to do in life?” Questions of identity relate to everything from hair color to religious views. Parents should permit this exploration, and support it. When you push too hard for your child to conform to your views, trouble happens. He may become confused about what’s important to him. Of course, there are family and societal values to be enforced: safe and ethical behaviors. Allowing your child to experiment with substances is not the thing to do. Permitting your child to dress provocatively is not the thing to do. But you may consider letting your child dye his hair. She should be able to select (safe) friends. He may wonder aloud (appropriately) about his sexual, religious, or political orientations.

Forming an identity can take a while. Be patient. This stage spans several years of awkward fashions, silly fads, and important work on the self. Continue to love and support your child through this sometimes difficult stage. Support especially the times when she sticks to her values, while peers do not. For example, praise your son when he elects not to drink alcohol at a teen party.

Avoid being defensive. For kids this age, everything is grist for the mill. Your child may call your rules too strict. She may accuse you of invading her privacy on Facebook or Twitter. He will say things at home aren’t fair. She may say your religious or political views are wrong. While taking into consideration your child’s view (she may have a good point!), remember that her accusations have more to do with her questions about herself. Matter-of-factly state your views, don’t attack his, and show your child how to communicate differences with respect.

An important, final note: mental illness is the arch enemy of good self-esteem. It ruthlessly attacks self-esteem. This can and does happen even for kids who have great parents. Mental illness can interfere with the development of good self-esteem from toddlerhood and up. When a child has poor self-esteem, particularly within the context of a supportive home environment, it’s a red flag for mental illness. The usual culprits are depression, anxiety, and attention problems. Signs of low self-esteem include:

Recurrent, unjustified shame and guilt

Hopelessness about the future

Feeling unlucky, punished, or “waiting for the other shoe to drop”

Suicidal ideas or behavior

Self-harm ideas or behavior

Children with good self-esteem have experiences–often provided to them by parents–that prepare them well for their future. They expect to succeed in what matters most to them.

Once upon a time, a scientist named B.F. Skinner was playing with rats and pigeons. He had this idea, that all behavior had to do with consequences. Wait! This story gets better. Mr. Skinner invented a fancy box for the animals. The box had levers, lights, loudspeakers, food–the works. The box’s floor was an electrical grid. After a series of experiments, the animals did what Mr. Skinner wanted them to do (like press the levers) when they were rewarded. If the animals did something wrong, the poor little guys got electricuted. The animals learned, over time, to do the “right” thing and to avoid doing the “wrong” thing. And everyone lived…happily?…ever after.

Well, Mr. Skinner did anyway. His work is famous in psychology. He showed us that rats, pigeons, and people are motivated by consequences. Our behavior is shaped by our environment. When a behavior is rewarded, we do it more. When a behavior is punished, we do it less. Mr. Skinner shrugged off Freud’s ideas about mysterious, inner drives and urges. Behavior is as simple as A-B-C: Antecedent, Behavior, Consequence.

Understanding Skinner’s work can save you hundreds of dollars in child therapy. If you want your kid to behave, then use consequences.

This is SUPER important: ld When you reward a desired behavior, they’ll do it more. Punishing a bad behavior works, but not as well as rewarding a good behavior.

So what’s a reward? Giving them something they actually want, or removing something they don’t want. Rewards are as unique and individual as your child, but most kids feel rewarded by: more leisure time, less chores, more freedom, less demands, more praise, less criticism, and so on. If you reward kids consistently, their behavior will get better. Also-once in a while-going above and beyond with rewards works too.

It’s pretty common, after a few sessions with a therapist, that parents are given instructions on how to use a behavior chart at home. (Thank goodness no one recommends Mr. Skinner’s electrical box.) Behavior charts can be very simple or pretty complex. Start with a simple one. You can do this with your child. Decide how many behaviors your child will work on. Kids ages 2-5 should have only about 4 chart behaviors. Kids ages 6-10 can have 8 chart behaviors. The limit for older kids should be 10 chart behaviors. The behaviors should be specific, but simply stated. For example, “If I use it, I clean it.”

Get a piece of posterboard. Make 8 columns from top to bottom. Leave the leftmost column blank. In the second column, at the top, write “Monday.” Moving left to right, write the remaining days of the week-one in each column. Leaving room at the bottom of the page, make as many rows (lines from left to right, under the days of the week) as you need for the chart behaviors. Write each behavior in the leftmost column, one per row.

At the bottom of the chart, write the exchange rate. How many daily stickers does your child need to get the reward? To start, shoot for about 80%. Same for the weekly stickers reward. Then, as behavior improves, make the ratio of behaviors-to-rewards higher, so that the child will eventually need 100% stickers to get rewards.

What’s the deal with the stickers? Once a day (about 2 hours before bedtime), you and your child will review the behavior chart and discuss how he did. He gets a sticker in the day’s chart behavior, only if he did it. He does not get a sticker if he did not do the behavior. Apply or withhold the reward as appropriate.

Stick to your plan, mom and dad! If your child did all the chart behaviors, then he gets the reward. Period. Even if later he misbehaves or you feel angry with him, he still gets his reward. Same goes for withholding the reward. If your child did not do the chart behaviors, no reward. Not even if you feel sorry for your child. Not even-especially not even-if your kid is throwing a tantrum about not getting the reward.

A behavior chart should be used consistently for about 3 weeks, before you can determine if it’s effective or not. Use Mr. Skinner’s research to mindfully reward your little rats and pigeons! This stuff really works.

IQ–what an elusive subject! What is it? What does it mean? How is it measured? What is a normal IQ? What does “gifted” mean? Where does IQ come from? Does it change over time? Can IQ be improved? Read on, reader.

IQ is a number that represents a person’s ability to make use of knowledge: acquisition, comprehension, storing, analyzing, synthesizing, reasoning, producing, and communicating. There is a long history of debate about the definition of IQ. Even while the debate continues, psychologists administer standardized tests to measure IQ. What’s being measured? Visual-spatial skills. Speed of thought. Reasoning and inference abilities. Fund of knowledge. Capacity to use “mental scratchpad” to hold and move images and concepts. Adeptness at communicating what you know. Fine motor skills. Common sense. IQ tests define IQ as composed of these many skills…rather than one global ability. But, one overall score is yielded by a mathematical formula that combines many subtest scores.

IQ scores range from below 70 to over 200. Beyond 200, it’s difficult to measure; these are IQ scores of geniuses who can graduate from ivy league schools before they can drive a car. Over 80% of the population has an IQ between 80 and 120. Scores of 80-89 are considered to be in the Low Average range of intellectual functioning. Scores of 90-109 are Average. Scores of 110-119 are High Average. An IQ of 125 is considered by many schools to be “gifted.” Scores of 120-129 are Superior. And scores above 130 are Very Superior. IQ scores are based on a person’s test performance compared to others their age.

This is important: To do well on IQ tests, a child must be engaged, focused, emotionally regulated, and motivated to do well. This means that children with mental illness sometimes do pooly on IQ tests. Does this mean they are “stupid?” Not at all. A child with Asperger’s Disorder, for example, may simply not be motivated to follow the instructions. A child with ADHD may not have the ability to pay attention when necessary. But these kids are often, in the real world, just as smart as their peers. A child can do poorly on IQ test for a number of reasons, but can do well only if she is truly able. Therefore, it is possible for IQ tests to underestimate a child’s intellectual abilities. But, an IQ score can never overestimate a child’s smarts.

An IQ number is handy, especially in academics. While IQ tests do not directly measure a person’s capacity to learn, they do show how well a child is likely to do in school. A child’s IQ score(s) helps parents and teachers form reasonable expectations for a child’s academic progress. IQ scores are the foundation of knowing, truly, if a learning disability is present. (Even though, in Illinois, schools have moved away from using IQ in this way). IQ tests can outline a child’s specific strengths and weaknesses. Although they are not diagnostic (e.g., they do not in themselves show ADHD), IQ tests can point parents in the right direction for next steps in treatment.

How does a child “get” his IQ? Hard to say. There’s a genetic component, linking especially the child’s mother’s IQ to his. There are also very strong environmental correlates to IQ. Love. Diet. Sleep. Safety. These are foundations that help support brain growth. Studies have shown that the amount of brain growth in early infancy is linked to IQ.

IQ tests are available for very young children. There are even ways to guess an infant’s IQ (hint: duration of stare). Standardized IQ tests are available for children as young as 2 1/2. IQ tests are sometimes required for admission into elite or private schools, where tests are given when children are 5 or 6 years old. In the psychology biz, we say that “IQ is generally thought to be stable after about age 12.” This means that whatever score a 12 year old achieves, he is likely to get roughly the same score when he’s 15, 20, 30, and so on. (In middle age, IQ scores tend to change: speed scores go down, knowledge scores go up). Age 12 is the magic number for a child’s cognitive development, the age when he can reason with relative sophistication.

Yet, psychologists know that a child’s IQ can change over time, even after 12. Most times, the change is not significant. A new study found that significant changes do occur, and concludes that changes in IQ reflect changes in ability. Remember that IQ is measured by tests that look for certain things. If a child has been skipping school, he’ll do poorly on parts of the tests that measure fund of knowledge. If she took cold medicine on the day of the test, and is a cognitively “fuzzy,” she may struggle in speed tests. Environmental factors can always play a role in changing IQ scores. But that is not what the researchers are saying. They’re saying that, based on changes in brain development, children’s intellectual abilities change. The sample size in the study was small, but it is an interesting observation.

So, if IQs change (significantly or not) can you improve your child’s IQ? You can sure help her improve IQ test skills, so she’ll score higher.

From ages 0-2: Read to your child. Often. Talk to him, using direct and sustained eye contact. Turn off the TV. Don’t buy the “education-based” video games. Love and praise your child. Play music you like for her (it does not have to be classical music). Explain everyday things to him. (Tell her why orange juice can sting a cut on a lip. Tell him why a hot stove must not be touched.) Praise your young scientist for repeating things over and over. Play peek-a-boo and hide-and-seek. Enforce a healthy diet, and try for organic foods if possible. Use routine, with predictable consequences for behavior. Introduce math concepts. Sing the ABCs. Make sure your baby gets enough sleep.

From ages 2-7, a child should be exposed to new things-music, sports, subjects, activities. Keep reading aloud to your child, and praise her efforts to read to you. Talk to your child about why people behave as they do. Who makes the rules in society? Why? Buckle down on homework, establishing high expectations for work habits. Extra work (school worksheets during summer) is recommended in reasonable doses. Homework should not be a fight. If it is, talk to school teachers or a child psychologist. This is the age that learning disorders can start to show. Get a handle on them early. If you have the opposite issue–your child wants to learn more than you can possibly teach–try to connect her to an expert in her field of interest. Perhaps a college professor would be willing to tutor your child for a couple hours on a weekend. Schedule playdates. Continue healthy sleep and diet activites. At this age, children are scientists. Conduct fun and interesting household projects that help your child explore their world. Play guessing games such as, “I spy”, and “I’m thinking of something…” Do puzzles and card games.

Children 8-12: Encourage independent reading and books-on-CDs. Enforce healthy sleep and diet. Limit TV and video game time. Be an active participant in your child’s academics, remembering that you are doing him no favors by completing homework for him. Teach work skills, including: organization, time management, scheduling, focus. Praise your child for good report cards, but avoid monetary rewards for them. The goal is to help your child internalize the value of good grades, and not simply work for an external reward. Use intermittent reinforcement. Listen to teacher’s feedback about any problematic academic or social behaviors. Listen to your child. Encourage her to pursue her intellectual passions (which may not be theoretical physics or advanced mathematical theory). Institute a “family game night,” where you play cards, puzzles, or other games that help build reasoning skills. Introduce your child to newspapers and have easy chats about what is happening in the world. Talk about governments, nationalities, and cultures. Explain real-life issues like, “why do we keep our money in a bank?” “what should you do if a bully picks on you?” and “why does the guy from the gas company read our meter?”

Ages 12-18: Children become increasingly independent. The foundation for IQ is already set, but test performance can improve for some children. There is no substitute for attending school regularly, paying attention in class, and doing homework. These are musts. Keep a close watch on your child’s use of electronics. Phones, video games, and computers can interrupt sleep, cause social disruption, and distract children from work. Help your child link her academic performance to her long term goals. Consider hiring a peer tutor, someone your child can actually tolerate. Help your child continue to build work skills such as organization, time management, avoiding procrastination, and breaking down big assignments into small “do-able” parts.

Our kids may not become Albert Einsteins or Stephen Hawkings, but they can learn and improve skills that help them get higher IQs.

The Centers for Disease Control reported recently that about 1 in 25 teenagers take antidepressant medications, writes the Huffington Post. Depressive episodes in adolescents can look different from adult depression. For one, teens tend to show more irritability than sadness. Another difference is that teens are not as adept as adults in articulating issues associated with depression. Teens who meet criteria for a diagnosis of depression also usually have at least 4 of the following symptoms: (1) loss of interest in activities that used to be pleasurable to them, (2) changes in appetite or weight–either increases or decreases, (3) sleep problems, including troubles falling or staying asleep, or sleeping too much, (4) seeming either physically slowed-down or physically agitated and restless, (5) feeling fatigued or out of energy often, (6) feelings of guilt or worthlessness, (7) problems concentrating or making decisions, (8) recurrent thoughts of death or suicide. Depression is more likely to affect females. It also runs in families. Children who have not yet reached puberty are more likely to have depression in conjunction with other disorders–such as ADHD, Anxiety, or Disruptive Behavior Disorders.

If you suspect a teenager you know may be depressed, you should take action. Schedule an evaluation with a child psychologist. There are evidence-based treatments for depression, most of which are based in cogntive-behavioral therapies. You should notice symptom improvement after 12-16 weeks of treatment. If improvement is slow or nil, consider making an appointment with a child psychiatrist to discuss medication that may be appropriate as an adjunct to therapy.